山形大学紀要（医学） 第35巻 第2号（2017)108-114
Autologous transfusion in radical prostatectomy:
Assessment of coagulability by rotational thromboelastometry
Nozomi Yashima，Tomofumi Watanabe, Misato Kurota, Airi Kumasaka
Futaba Kurihara, Kei Otaki, Shinya Oda, Kaneyuki Kawamae
Background: Radical prostatectomy can lead to severe bleeding. Therefore, patients undergoing this
procedure often donate autologous whole blood prior to surgery. In this study, we aimed to evaluate the
clinical efficacy of transfusing preserved autologous whole blood on coagulation activity as assessed by
rotational thromboelastometry (ROTEM).
Methods: This study included patients who underwent radical prostatectomy and donated 1200 mL of
whole blood prior to surgery. Blood samples for ROTEM analyses were drawn at four points; after
induction, prior to transfusion of autologous whole blood, at the end of surgery and the morning after
surgery. Clotting time (CT), clot formation time (CFT) and maximal clot firmness (MCF) were measured
using EXTEM tests; MCF was measured using FIBTEM tests.
Results: The average blood loss in 11 patients was 1635 ± 954 g. In EXTEM, CFT was significantly
prolonged and MCF was significantly reduced prior to transfusion. These parameters were significantly
improved by the next morning. In FIBTEM, there were no significant differences among samples
obtained after induction, prior to transfusion and at the end of surgery. In contrast, MCF was
significantly improved the morning after surgery.
Conclusion: ROTEM parameters were impaired during the procedure. Transfusion of autologous whole
blood did not alter these parameters during the intraoperative period.
Key words : Autologous blood transfusion, Radical prostatectomy, coagulopathy, rotational
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